9808 3RD AVE SE 2024-11-07 - Laserfiche WebLink

4• A: ECIEOVEIN 11, .... BUILDING PERMIT APPLICATI 23 CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requir and U mbeOr of cop i s requirWor review, WASHIN GTON then drop off completed applicationplus all required submittal b documents to P PP q tre a Drop Box. CONTACT INFORMATION:(P)425-257-8810 E P I O ermitService everettwa. retl� t� (Blue or Black Ink Only Please) PROJECT SITE INFORMATION I \..Muit very/R.6o 'f PROJECT SITE ADDRESS: STREET ci b Q$ . �� J'� �S'�1 E PARCEL#: i c y or a-(J rr STATE W A ZIP [ 82'3 S SUITE/UNIT#: Pr" 1 FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential): -0 1.)c6-L,*S 6(?-0(.1-er, I LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) i 1, CONTACT INFORMATION ,", OWNER NAME: g-VETZ.G TT 11-0t1S 14V CsAvyttoR.1 Try OWNER MAILING ADDRESS: STREET 3107 e...60111 !t t L Om STATE W 4- ZIP q g`Z,10 OWNER PHONE: OWNER EMAIL: tr^q t>-74L�Jl,� k�Q J k4 ,a/� � � ( ` :I¢; CONTRACTOR COMPANY NAME: �/-► I-0-QC, Caws �G'�`f DA) ii, WA STATE CONTRACTOR LICENSE#(REQUIRED):VtrSTr CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): s I$S 3 CONTRACTOR ADDRESS: STREET/ j�S t '4 _-�.IJ`-3 r°u "I� I L' �j cnv 1... . S T4.J ir��+S STATE LtJ�at ZIP c Q Z S 116 CONTRACTOR PHON . Z06� $$'a SS'`'1 Z CONTRACTOR EMAIL:304J( . L 4.sT-r 7GICCp N. CO•r• % il' ill PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) 1:4 CONTACT NAME: CONTACT PHONE: 21 - t, L 'T�r owt.,,w `� Z�3S� 3 r n f_I ZL✓ E. CONTACT EMAIL: ea...tar_ h $ e�let 4. Ctr VALUATION OF WORK:$ 17S13.000 .., ASSOCIATED LAND USE PROJECT#(if applicable): 1kr 4'` (Valuation shall include the prevailing fair market value of ell tabor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING: 4 -e L �( -i-vu4E - !i il PROPOSED USE OF BUILDING:/ -'W S ANe HEAT SOURCE: ❑Oas L'18Electric ❑Other BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ultl-Family-#Units: °Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ONew Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use 1,t1 Uf, ❑Modular ❑Portable ORe-roof ❑Eaderior Alteration ❑Tank(above ground) Accessory Structure `'- ❑Fence over 7ft high ❑RackStorage OPool/Hot Tub ❑Tank(above ground) Other: DESCRIPTION OF WORK: '{bus I i) 41 4 A- 1 Zeovm 'Fsu..,ki-4$d., p. Xi- •wr-S DieSfed 21-, Po fe. 24..bus1a swag-s ;09 ?1.,4 5.4n5 OAT. v-•cr� 'i''; =VSv(TTsaa✓, $Nt i'Z o Oc, fi l+•s•S• '� 4�-1.tit $ its( ' "s'PI"'r''e..GS f if g(LL. L vEe,-1— f{6 Y ACKNOWLEDGEMENT.-I have reviewed this application and confirm the information contained herein Is true and correct.Work done pursuant to this gem*must comply with current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the ,Building Official before being authorized under any circumstance.tam the owner,or tam authorized by.the owner of this property to perform the work for which application Is,made, i and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. 6. ;I City of Everett Official Use Only h' Z PERMIT#`° I- S-- 30 • 3 .r�L� � -- t�0� Owne Authorized Agent Signature Date (Revised 4/21/2022) `